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Diet and Diabetes

Diet and Diabetes

November 09, 2011 12:00 p.m. – 1:00 p.m. (EST)

Gina Sweat, RD

25.8 million children and adults in the United States—8.3% of the population have diabetes. To better understand diabetes, it helps to know more about how the body metabolizes food. For diabetics to manage their glucose levels, they need to balance diet, exercise and medications (if taken).

Cleveland_Clinic_Host: Today's Live Web Chat, "Diet and Diabetes" with Gina Sweat, RD will begin at 12:00 pm (EST). Please submit your questions by typing them below and then clicking 'Ask'.

Cleveland_Clinic_Host: Welcome to our Online Health Chat "Diet and Diabetes" with Gina Sweat, RD. We are thrilled to have her here today for this chat. We will begin answering questions in just a couple of minutes. We are already receiving a large amount of questions. Please keep in mind that medical related questions surrounding medications and diagnosis should be directed to a physician.

Francois: Can anxiety related stress raise the fasting blood glucose reading in those having labile hypertension, where blood pressure spikes not only in the doctor's office but also in other situations of even minor stimuli? For the last few years my fasting blood glucose has been around 125 which is higher than would be expected from my HbA1C which has been around 5.5%. Furthermore, the fasting blood glucose on my home glucose monitor has always been less than 100. At the end of last September the OGTT reading two hours after taking 75 g of glucose was 247 with the fasting glucose at 128 and HbA1C at 5.5%. I have never taken any diabetes medication. Is HbA1C used as a diabetes diagnosis test in America? If so, what happens when OGTT and HbA1C give conflicting results? Last January WHO approved HbA1C as a diabetes diagnosis test.

Gina_Sweat_RD: Yes, anxiety-related stress can raise your blood sugars regardless. In order to diagnose a person with diabetes different text are necessary such as: the Fasting blood glucose, the 2 hour glucose tolerance test, a random glucose and your symptoms, you personal doctor can order these test.

Cleveland_Clinic_Host: We are getting some great questions and Gina is trying to be as specific as possible in her answers. Thank you for your patients.

Skburman: I am 49 years old, male and pre-diabetic. Should I worry about the amount of fruits which I eat? Any guidelines?

Gina_Sweat_RD: Yes, you should limit the serving of fruits you should have in one day because they have carbohydrate and they can raise your blood sugars. The total amount of carbs will be determined based on weight, height, and physical activity. If you are limiting the carbs to 180 total per day, then limit the fruits to no more than 3 per day. These will give you an equivalent of 45 grams of carbs per day. For further reference, search the Exchange list.

Azph78: If you are ever dx w/ diabetes can you change it around to no longer having it?

Gina_Sweat_RD: Diabetes is not curable, but certainly you can keep it under control or under remission if you control with your carbohydrate intake and stay engaged on with physical activity

Healthlady: I am hearing a lot that either Stevia or agave are better sweeteners to regulate glucose levels. Is this true?

Gina_Sweat_RD: Stevia is a good sugar substitute, but agave it's not. Stevia will not raise blood sugar because it is carbohydrate and sugar free. Agave will raise it because it contains 5 grams of carbohydrate per tablespoon.

Depotdad: Can you give me information about the weight loss program offered by CC cost, where, when etc?

Gina_Sweat_RD: Please note that this program is currently on hold. We are working to get it back up and running as quickly as possible. When we do get this program going again, please note that it is not specific to those with diabetes and is open to all who are interested in weight loss.

Gina_Sweat_RD: Non-Surgical Weight Loss Program. This program will be open to anyone over the age of 16 who is interested in losing weight. The program will not only provide participants with a dietary plan for weight loss, but will also provide tools for effective psychological behavior modification. Requirements: before the participant can enter the weight loss program, medical clearance needs to be obtained either from the participant’s own Primary Care Physician (PCP) or the program's PCP. The "Weight Loss Medical Evaluation and Clearance" form must be completed by the participant’s own PCP and reviewed by the program's PCP before the participant can schedule the initial appointment with the psychologist and dietitian. If Cleveland Clinic in Florida accepts participant’s insurance, the program's PCP's visit for clearance can be billed through the insurance.

Gina_Sweat_RD: Length of Program: The program will run for 9 weeks. The appointment will be done one-on-one on Wednesday with the dietitian (60 minutes) and the psychologist (75 minutes). These will be scheduled back-to-back. Appointments 2 through 9 will be in a group setting and will meet on Monday for 60 minutes with the nutritionist and for 60 minutes with the psychologist. These group appointments will also be back-to-back. Participants will register at desk 23/24 to get weighed in by the dietitian. The groups will be held in a David Jagelman Center conference room.

Gina_Sweat_RD: Cost of Program: the fee will be $590 for all 9 weeks of both services payable at the first visit. This program will not be covered by insurance. For additional information, please call: Gina Sweat MS, RD, LD/N at 954.659.5874

Healthlady: Do you know any good recipes or websites for diabetics?

Gina_Sweat_RD: Two good websites where you will find great recipes and other important information for diabetics are: http://www.diabetes.org/ http://www.joslin.org/

Lilly: I have type 2 diabetes and I follow a 1200 calorie diet. How do I know how many carbohydrates to eat?

Gina_Sweat_RD: The number of carbohydrate you need a day is based on your weight, height, physical activity, medications and weight status.

Trjpw: I have a patient, male, mid 50's, BMI 36, recovering smoker, who does not feel he has a problem. Short of kicking him, how should I motivate him to be more concerned about his health? DM II, random blood sugars around 130 by finger stick.

Gina_Sweat_RD: It might be beneficial to refer him to a clinical dietitian or even a psychologist. Either of those professionals can help in challenging him to live a healthier lifestyle.

Lilly: With Thanksgiving around the corner can you give some tips on how I can still enjoy my day and keep my blood sugars in control?

Gina_Sweat_RD: You can still enjoy eating your traditional Thanksgiving food, but the key is portion control. For instance, instead of having a regular slice of apple cake you eat only a quarter of the piece or even substitute it for baked apple with brown sugar and fat free whipped cream. Instead of having 2 serving of starch, potato and noodles, limit it to just the potato.

Mljtwill: Does the monthly menstrual cycle affect diabetes at all?

Gina_Sweat_RD: The menstrual cycle can affect diabetes if your cravings for sweets would get out of control or if your menstrual cycle promotes anxiety or stress.

Jennharris2010: Is it true that when you have diabetes you should eat small more frequent meals and why is that?

Gina_Sweat_RD: Eating more frequent meals can help maintain your blood sugar under control as long as the meals are carbohydrate controlled and the carbohydrates are distribute evenly through the day.

Gina_Sweat_RD: Carbohydrates break down into glucose or sugar in your blood stream and this is why they can impact your blood sugar the most. Proteins will not affect blood sugar, but excessive intake of protein can increase calories in your diet and promote weight gain. Weight control is one of the goals of people with diabetes.

Cleveland_Clinic_Host: We have approximately 7 minutes left in the chat. We will answer just a couple more questions. We apologize if we did not get to your question. If you have additional questions after the chat, please use our contact link clevelandclinic.org/webcontact to submit your questions.

Divapearl: My fasting blood sugar reading is usually 139-149. What foods should I eat to reduce it?

Gina_Sweat_RD: Control the portion size of carbohydrates, starches, fruits, dairy products at each meal. In addition, avoids foods with sugar or added sugar, sweets, candies, chocolates, pastries. Increase intake of fiber as fiber is known to reduce blood sugar. Examples of high fiber foods are: whole grains, fruits with the skin, veggies, and legumes.

Healthlady: I keep hearing about good carbs and bad carbs. What is the difference? Is Quinoa a good carb?

Gina_Sweat_RD: Good carbs are usually referred to as complex carbs, like whole grains, veggies, fruits etc., but these can also have an effect on your blood sugar.

Cleveland_Clinic_Host: I am sorry to say that our time with Gina Sweat, RD is now over. Thank you again, Gina, for taking the time to answer our questions today about Diet and Diabetes. To make an appointment with any of our dietitians, or any other specialists at Cleveland Clinic Florida, please call 877.463.2010. You can also visit us online at vanity clevelandclinicflorida.org.

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